Are we beginning to feel the strain of too many webinars?

Andrew Coutts

Pre Covid-19 there were only a few opportunities to jump online onto a presentation or discussion about fertility. Some of the forward thinking and marketing driven treatment providers were ahead of the game and were already sharing webinars featuring patient testimonials, clinic walk throughs and expert talks before the first Coronavirus infection. A few of the more active Insta Influencers had spotted the potential of the online ‘Live’ and were using it to share education, offer advice or to merely promote themselves. For most of the time, it worked.

Then in the early spring of 2020 Covid-19 started creeping and within a relatively short period it had lept on societies across the globe, pausing, cancelling and shutting down everything in its way. The fertility field was no exception, clinics closed, treatments were cancelled, hopes were put on hold.

Like many other countries the UK went, after polite consideration, into full lockdown in March 2020. There was general consensus that staying away from each other was the right thing to do so as a nation we took our ball and went inside. And, we rolled slowly forward.

Like every other field of activity, the fertility community took a breath, stepped back but then thought, what next?. Our biological clocks didn’t stop for Covid-19 and as each day and month passed the ticking got a little louder. Patients sought assurances, answers. Professionals did their best to comfort but the virus caused uncertainty and this uncertainty which began as a ripple, then raged across the tightly knitted fertility community.

Trying to conceive and failing is one of the most stressful emotions you can experience and historically it was an emotion that wasn’t shared, even among close family and friends. I brushed against the fertility field as a patient twenty years ago and ten years later as a professional. In that time there was a noticeable shift in the way individuals and society viewed infertility. As more of us were becoming affected by it, the more fertility stepped out of the shadows. In short, fertility joined the mainstream.

A new profession was born. ‘Fertility Specialist’ became a title not solely owned by the medical doctor; now it began to be adopted by a new crowd of individuals and agencies offering emotional support, coaching and even fertility travel, my own area of interest. This groundswell of people queing up to share information and advice on every aspect of infertility meant that in many ways the fertility patient too, became a Fertility Specialist. Infertility had arrived and we were at last beginning to talk about it.

Then, bang. Coronavirus reared its ugly head and started to have a real impact on people’s ability to access time limited fertility treatment. Older patients wondered if they were going to be ‘too old’ to get their treatment – Even (good) private clinics now have an upper age limit for patients – others were anxious about their ‘frozen’ embryos stored in laboratories and others speculated whether treatment would actually start again.

 The fertility community was crying out for a ‘cure’ like the rest of society. Their cure however didn’t come in a syringe, it emerged in the form of the Webinar. After weeks of uncertainty the webinar became the school yard for adults interested in fertility, an online haven for ideas, rants, frustrations, tears but also for reassurance, comfort and support.

My inbox and social media platforms bulged daily with invites to Insta Lives, Zooms, and Teams sent from all over the world. Speaking as a ‘Boomer’ I was blown away, telemedicine had suddenly come of age and patients were beginning to benefit from online services that hadn’t existed six months previously. Clinics and clinicians were talking to patients in their own homes; patients were talking to each other in safe, private environments and couples were ordering products designed to offer the promise of parenthood.

Webinars were running headlong towards the sombre spectre of Covid-19 and there was a great sense of togetherness and community. Some great examples of education and support were provided; myivfanswers.com launched over 250 videos and webinars that brought together ‘proper’ fertility specialists from all over the world. Closer to home, ‘The Man cave’ Instagram webinars offered the inspirational and honest thoughts of a male fertility patient.

Six months after the first wave of fertility webinars there appears to be no wane in the number of webinars and videos going live. A recent conversation with a colleague, and the reason behind this article, got me thinking, are we beginning to feel the strain of too many webinars? My eyes glazed when he calmly announced that he had spoken at 42 webinars in the previous three weeks, quite a feat at two a day. I wondered what there was left to say.

As the levels of compliance that were upheld by so many in March begin to fray in the face of lockdown yo yo I wonder if the fertility community too has also become tired of the webinar. I have randomly begun to surf Lives and videos and notice invariably there might be 3 people watching, I imagine the presenters disappointment as three become two as I leave.

And as we huncker down for what is likely to be a long winter it will be interesting to see if the fertility webinar can regain and maintain its popularity or whether like Covid it will slowly take a step back into the shadows.

Whilst we wait, my first webinar, ‘It Doesn’t Stop at the Pot’, a male only discussion on male fertility diagnosis and treatment is going live on Wednesday 4 November, to mark the UK’s Fertility Week. I have decided to play rather than to shout from the touchline. Hopefully we will attract a good crowd.

Andrew Coutts is the Chief Executive of the International Fertility Company and a PhD Research student at the Centre for Reproduction Research at the Du Montfort University.

A New Year, A New Experience

Andrew Coutts

The talk showcased the prestigious private healthcare institutions who partner MHTC and offer breath taking facilities with jaw dropping medic/patient ratios and cutting edge treatments and technologies. But, what was equally impressive was the way Sherene spoke about the individuals involved, the care givers, the support workers and the medics who were committed to providing the highest standards of care and treatment to ever growing numbers of patients from across the globe.

So too, was the emphasis placed on the care and support offered to health tourists from the moment they arrive in the country with access to dedicated Concierge services and Lounges in the Kuala Lumpur International Airport (KLIA) and Penang International Airport to the moment they leave.

This level of service is not offered merely as ‘front of house’ effect, it continues throughout the patient’s stay in Malaysia where they and their travelling companions can access medical, wellness and tourist facilities.

In my job as an international fertility travel consultant I travel the world reviewing services, facilities and professionals however MHTC and the ‘Malaysian Experience’ offers a layer of comfort that I have rarely seen before.

To put it simply. This is not just medical tourism, this is ‘wrap around’ care and support at its most sophisticated.

Like the majority of events, campaigns and initiatives planned for 2020 the highly anticipated, “Malaysia Year of Healthcare Travel 2020” and linked “Visit Malaysia 2020” campaigns had to be postponed but despite Covid-19’s best efforts Malaysia has been both robust and successful in its handling and containment of the pandemic which has caused world wide devastation and disruption.

At the time of writing (September 2020) Malaysia is reporting a recovery rate of 96.6% for those that have been infected by the disease which puts it near the top of the list of countries who have been most successful with its medical and social distancing interventions. The World Health Organization (WHO) commended the country for being one of the best prepared for the outbreak and its Health Director-General, Tan Sri Dato’ Sri Dr. Noor Hisham Abdullah has been recognised as one of the ‘top three doctors’ in the world by China Global Television Network (CGTN). It is no wonder therefore that Prime Minister Tan Sri Muhyiddin Yassin recently proclaimed,

“Malaysia is recognised as one of the best countries in dealing with COVID-19 and the death rates attributed to COVID-19 are among the lowest in the world”.

Malaysia’s response to the pandemic is another indication of its ability to tackle, supress and succeed in treating disease and illness. It is no surprise therefore that it has become one of the fastest growing destinations for medical travellers who arrive seeking interventions to treat, stabilise or cure.

Covid-19 has had an enormous short term effect on the country’s medical tourist trade and normal travel behavour patterns may not return soon but MHTC’s CEO Sherene Azli believes that the country’s experience and track record will enable it to bounce back, and bounce back with some impact over the next five years,

“Malaysia expects to welcome fewer than 300,000 medical tourists this year, compared with nearly 1.3 million last year but we are confident that our ambitious plans for recovery are realistic and sustainable”.

The Malaysia Healthcare Industry Blueprint (2020-2025) outlines strategies to catalyse industry rebound and enable Malaysia Healthcare to attain/achieve pre-COVID-19 performance by 2025.The blueprint aims to increase the revenue generated from healthcare travellers to a minimum of RM4.2 billion (US$1.01 billion) by 2025.

The blueprint is ambitious but the joined up approach to medical tourism with MHTC acting as the lynchpin to a collection of leading health and wellness providers, backed by central Government support will ensure that the country continues to lead in an increasingly competitive field.

By 2022 it is estimated that the global healthcare travel market is estimated to be worth RM82.7 billion.

Health and wellness tourism is ‘big business’ and despite a temporary pause in travel it will return, and return with gusto. Malaysia is prepared and will respond with the efficiency and competency it is known for.

My particular interest is fertility travel which is one of the fastest growing sectors of medical tourism. Falling fertility rates as well as individuals delaying parenthood, environmental factors and the emergence of new diagnostics and interventions have contributed to the rise in treatment providers and clinics encouraging cross border travel.

Results from the 2020 Fertility Travel Survey facilitated by the International Fertility Company highlight the main motivators behind fertility travel. These include cost, perceived success rates, treatments offered and the level of care and support offered by providers. Recognised as one of the most comprehensive fertility travel surveys ever undertaken, 97% of participants said that would continue to travel once the temporary restrictions regarding travel due to the coronavirus pandemic were lifted.

So, how does Malaysia score on the top four motivators behind fertility travel and what might allow it to become recognised as the fertility hub of Asia?

Costs:

Treatments are affordable, with each in-vitro fertilization cycle costing between RM16,500 and RM20,600 (US$4,000 and US$5,000). Uniquely, there is also legislation in place to ensure that international patients are not charged any more than domestic patients for the same treatment.

Success rates:

Statistics from MHTC show that clinical pregnancy is successful in one in two fertility patients in Malaysia.

Support:

The Malaysian healthcare system is universally regarded as well-regulated and patients are offered fertility packages which combine health, wealth and tourism and include medical expenses, accommodation, airport transfers and cycle planning.

Treatments Offered:

Procedures widely available in Malaysia are ovulation induction with timed intercourse (TIC), ovulation with intrauterine insemination (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), assisted hatching (AH), blastocyst transfer (BT) and embryo and sperm cryopreservation. Other treatments include sperm and egg donation (a service available only to non-Muslims) gamete intra fallopian transfer (GIFT), zygote intra fallopian transfer (ZIFT) and frozen embryo transfers (FET).

Ticking The Right Boxes

Malaysia does seem to tick the right boxes for fertility patients looking to travel and with its Government committed to universal access to high quality healthcare for both the domestic and international patient facilities are on par with anything you might find in Europe or North America.

The country is using the universal pause on medical tourism to provide flexible alternatives to face to face consultations. These include online telemedicine support, maintaining communication between doctor and patient and preparing travellers to ensure they are ready to visit Malaysia when travel restrictions are lifted.

What I like about the Malaysian approach to fertility treatment

The current population of Malaysia is just over 32 million according to the latest United Nations data. It is relatively intimate country which provides a very warm welcome to visitors from all over the globe. Famed for its natural, cultural, historical and gastronomic attractions, its understanding and tolerance of religious and cultural differences it is cosmopolitan and transnational in every sense.

It has the infrastructure which is properly financed and supported to promote medical tourism and the blend of private and public participation ensures that all have bought in and are committed to the aim of making the country a medical destination of choice.

As a fertility practitioner advising patients about travel Malaysia makes all the right noises. Boosted by an English speaking population, and a comprehensive, sophisticated selection of fertility treatments and procedures that are available at significantly lower costs (and currency exchange rates) than many other fertility destinations it is no wonder that it is being seriously considered as the ‘fertility hub of Asia’.

This position has much to do with the professionalism, foresight and ability of the Malaysia Healthcare Travel Council which is able to provide a sector wide approach to medical travel. I have witnessed levels of support for the fertility traveller in many countries but although some of this support is superb it is only provided by individual clinics or groups. MHTC offer a high level of support and information to travellers and present a provider portfolio from which patients can choose the right clinic, hospital or treatment. They not only showcase the medical talent Malaysia has to offer but their collaboration with specific clinics and hospitals offers the patient reassurance regarding the quality of care each provides.

MHTC are a medical tourism facilitator but they are far more than that. They represent a medical tourism model which many other countries would do well to replicate; led by a charismatic CEO they have rightly come to ‘own’ the fertility space in Malaysia and have ensured that this niche area of medicine and science is quite rightly, beginning to warrant the recognition it truly deserves.

My advice. Why not try Malaysia. I am looking forward to it.

Malaysia Healthcare Travel Council (MHTC) is an agency under the Ministry of Health tasked to facilitate and promote the healthcare travel industry of Malaysia by coordinating industry collaborations and building valuable public-private partnerships, at home and abroad.

You can read more about the Malaysia Healthcare Travel Council here

Greece – Fertility destination 2021

Andrew Coutts

Choosing an IVF clinic can be a daunting task; there are many treatment providers in different countries offering diverse solutions to fertility issues and it is no wonder that patients seeking answers don’t really know where to start.

IFC is very pleased to act as an Ambassador for the Fertility Destination campaign which will enable anyone considering fertility travel an opportunity to learn about the very best clinics and professionals that individual countries have to offer.

The campaign launches with Greece – Fertility Destination 2021 which will showcase treatment opportunities; clinic facilities, professional opinions and visitor attractions.

The campaign which features Greece is particularly timely. In the recent Fertility Tourism Survey 2020 written by Andrew Coutts, Jakub Dejewski and Aleksander Wiecki, it was demonstrated that Greece is fast becoming one of the most popular fertility destinations worldwide. With high quality clinics, staffed by experienced professionals offering excellent levels of care and support it is easy to see why. Add in, accessible travel links, a good climate and a wealth of history and you have the perfect destination.

We look forward to sharing more as the campaign unfolds but for now, take a look at the article below which sets out why Greece was chosen as the first Fertility Destination!

Greece – Fertility destination 2021

Warm Mediterranean climate, tempting blue sea, impressive beaches, amazing historical sites and great food – these are just a few things that Greece is known for. However, not all of us may be aware of the fact that one of the most popular holiday destinations in the world also plays a very important role on the medical tourism map. It turns out that Greece has a lot to offer in terms of in vitro fertilisation and reproductive medicine in general. If you have been considering IVF treatment abroad and were wondering whether Greece was the right choice for you, we say: yes! And here are some reasons why.

You will find many of the world’s top IVF in Greece, combining high-quality services and reasonable rates. These units, mostly located in Athens, Thessaloniki and Crete, apply excellent practices and are staffed with both state-of-the-art technological equipment and trained specialist doctors. The clinics are certified by internationally acclaimed organisations, which assure not only innovation but also safety and quality of clinical, surgical and laboratory procedures.

What is more, all the IVF clinics in Greece operate under license from the Greek National Authority of Assisted Reproduction. It is a national body that makes controls, gives suggestions, collects data and keeps records of every single case related to assisted reproduction in the country. And finally, what is probably most important from a patient’s point of view – first class fertility treatment is offered in Greece at a much lower cost than in other top European fertility destinations.

Greece has definitely a lot of advantages over other countries in terms of infertility treatments and services – one of them is its liberal IVF legislation. Issued in 2005, it allows for most IVF methods (e.g. intracytoplasmic sperm injection (ICSI), egg/sperm donation, frozen embryo transfer), surrogacy arrangements and genetic testing options (such as PGT-A and PGD). The age limit for women undergoing IVF treatment is 50 years old and there are no exceptions in terms of marital status. It means that all the procedures are available to both married and unmarried heterosexual couples, single women and women in lesbian relationships. In case of the latter, it is only required that one partner states she is going through treatment as a single woman and signs a notarial deed.

Greece is one of the countries which allows anonymous egg and sperm donation. According to the Greek IVF law, information on a patient and the child conceived via donation will not be disclosed to an anonymous donor – and vice-versa. Donor anonymity has a lot of advantages: the development of egg/sperm banks, large pools of donor candidates and the lack of waiting lists for donation treatments. The latter will surely be considered as a great asset by advanced-age patients who find time very precious and cannot allow themselves to wait months for the treatment to start.